Good Health Outcomes Start with Access to Good Food

“As there is enough food in the world, hunger is a result of political decisions. Food insecurity results from ineffective policies (social, agricultural, economic and health) at local, national and global levels and from decisions which do not consider the elimination of poverty, hunger, and food insecurity, and the development of sustainable food systems to be priority issues.”

~Laura Kalina in Building Food Security in Canada: From Hunger to Sustainable Food Systems: A Community Guide 2nd edition.

It is possible that all we need to sustain, nourish and heal grows on this planet. Equitable access to produce and food that has been grown or raised without off farm inputs is, in my opinion, a fundamental right, not a privilege reserved for those who can afford it. The United Nations has stated their position as such for a long time. Seventy years, in fact.

Poor Health Outcomes linked to Food Insecurity

A 2016 report from an interdisciplinary research team at the University of Toronto (PROOF), Ontario, Canada worked with the British Columbia Provincial Health Ministry to determine what factors contribute to poor health and poor health outcomes in British Columbia.

They used information gathered from self-report Community Wellness Surveys (completed 2005-2012) to evaluate various factors affecting overall population health including mental health and physical health.

They found that one (of several) indicator linked to poor health outcomes was Household Food Insecurity – ‘households not being able to afford the nutritious food they need to either maintain good health or successfully manage chronic health conditions.'(1)

Where’s the PROOF?

The following 13 minute video beautifully sums up PROOF’s research findings regarding Household Food Insecurity in Canada. One of the researchers, Valerie Tarasuk, tells it like it is and it ain’t pretty.

My hope is that health professionals, allied health professionals, social workers, teachers, early childhood educators and others who work with families watch this video and take into consideration the seemingly innocuous, yet very real factors that affect ‘best possible outcomes’ when it comes to health and well-being.

Before pointing fingers and exclaiming NIMBY, PROOF found that 65 percent of people in British Columbia (and Canada) who could not afford to put balanced and nutritious meals on the table were working families.

The provincial health authority with the highest rate of food insecurity in British Columbia was the Vancouver Island Health Authority with food insecurity rates at 25percent. Most numbers across British Columbia and Canada (with the exception of the Northern Territories which are significantly worse) hovered just over 10 percent.

Implications of Undernourishment

Given the significant implications of undernourishment, these numbers should be concerning. It is alarming that children living in Central Vancouver Island are almost twice as likely to have communication and cognitive difficulties as children living on mainland BC. Adults and children are also more likely to have chronic illnesses and life expectancy is just below the BC average.

Are these poor health outcomes the result of higher rates of food insecurity? According to PROOF’s research, the higher the food insecurity, the poorer the health outcomes. In their report, they specifically state that “food security is fundamental and necessary for healthy eating” (pg. 4).

They go on to discuss the potential health and social challenges that may arise from household food insecurity:

Birth outcomes and maternal health – poor nutrition during pregnancy can have a negative impact on both mother and infant.

Child development – among Canadian children and youth, food insecurity is associated with iron deficiency anemia and has been linked to the subsequent development of a variety of chronic conditions, including asthma and depression. According to PROOF, A Quebec study observed a two-fold increase in the likelihood of persistent hyperactivity/inattention among children eight years old and younger who experienced food insecurity between ages one and a half and four and a half years, even after accounting for family socioeconomic circumstances and parental mental health. In central Vancouver Island, preschool children were almost twice as likely as children from the rest of BC to be at risk for poor communication and cognitive outcomes (language delay, reading, writing and numeracy skills) based on the Vancouver Island Local Area Profile from 2014.

Health Status and Chronic Diseases – food insecure individuals report higher levels of poor or fair self-rated health, diabetes, heart disease, high blood pressure, food allergies. In Central Vancouver Island the top two causes of death were due to disease related to the circulatory system, and due to diseases of the arteries/arterioles/capillaries, ischaemic heart disease and cerebrovascular disease/ stroke, respectively.

Mental Health and Emotional Well-Being – food insecurity can increase the likelihood of depression and social isolation and is an independent risk factor for depression and suicidal symptoms in adolescents and early adulthood. Again, in Central Vancouver Island, mental health services use was well above average for BC.

Health Care Costs – in addition to poorer health outcomes, recent research in Ontario shows increased health care costs associated with food insecurity. According to PROOF, after adjusting for education and income, total annual health care costs in Ontario were higher for adults living in food insecure households compared to those living in food secure household. Specifically, for marginally food insecure household, health care costs were up 23 percent, for moderately food insecure households, 49 percent and for those household who experienced severe food insecurity the cost of health care went up 121 percent. Food insecurity has also been show to increase the probability that adults will become high-cost health care users.

The report goes on to discuss the monthly cost of food for families of four. The numbers indicate that low-income families would have to spend two-thirds of their income to afford ‘nutritious’ food.

A Food Paradise Paradox

There is an interesting paradox on Vancouver Island. The island is filled with much beauty. Farmers grow wonderful biodynamic food, not all are organic certified because the hoop jumping and associated costs are too much. Farmers’ markets abound, some seasonal and some year round. Organic food can be delivered to the front door. Some wonderful food is grown year round in shipping containers.

Fresh vegetables, herbs, free range eggs and chickens, jams, berries, apples, plums, pears and honey, just to name a few foods, can be acquired at quaint farm stands at the end of long driveways.

Some chain grocery stores buy and sell locally grown food first and ‘Community Farm’ stores are gaining more traction.

Fifty years ago, 80 percent of the food grown on Vancouver Island was sold on Vancouver Island. Today, that number is estimated to lie between 5 to 10 percent. Local farmers who have been around for a while will tell you about this phenomenon. Perhaps things are coming full circle.

Interestingly, all this abundant food is largely inaccessible or not accessed by people living in food insecure households. Although food continues to be reasonably priced at local farm stands, the farm stands are less than accessible for families and individuals who face financial shortages, serious and chronic health conditions and struggle to put food on the table. They often cannot afford to own a vehicle or the insurance to go with it.

To make matters more confusing, places that claim to carry local food or source locally such as ‘community farm stores’ and farmers’ markets offer nutritious food but at such high prices (between one to two-thirds more than chain grocery stores) making fresh, local food virtually inaccessible even if households ‘budget’ or make a deliberate ‘choice’ to buy local food as much as possible.

People on Vancouver Island, at times, resort to social media to request food donations for their families due to financial shortages as well as on behalf of ailing spouses or family members who want to use real food to attempt to reverse or stabilize their chronic or terminal conditions but cannot afford to do so.

Community development, new policies and advocacy are needed to address both the economic and social conditions of food insecure households. Since the food system affects us all in some way, we all need to be involved in finding lasting solutions to food insecurity. This is a given.

Needed Change

Access to good food for those who need it (such as those who are attempting to manage chronic conditions) is a complex issue and I certainly do not claim to have the solutions. But I believe that public awareness is a first step.

I wonder if the new way to feed people in our communities is to stop treating food as a commodity subject to market economics where a few big companies are winners and many individuals and communities are the losers. Food is a necessity, not a privilege.

For the People By the People

What if we grew food in the public realm where anyone could access it on a regular basis for free or minimal donation? Perhaps this doesn’t sound good for farmers; however, as the research shows, people living in food insecure households are not their target demographic anyway so my thoughts and ideas neither undermine their ventures nor take away their customers.

What if we made the conscious decision to grow food in the public realm in the form of community gardens or school gardens? Used islands and verges, gleaned food and were creative in how we got that food to the people who needed it most. If we live in extreme climates, we could grow food indoors (in malls, churches, community halls, seniors’ centers, recreation centers, resource centers, women’s shelters, windowsills) or in shipping containers.

The possibilities to provide nutritious food to those who need it are endless. It is a conscious choice that we must make as a society to feed everyone adequately. Let’s make sustainable food systems and food security our priority issue.